Effectiveness of treatment by coronoidectomy and active rehabilitation in Langenbeck or Jacob diseases. A retrospective study of 20 cases.

BACKGROUND: The objective of this study was to evaluate the mouth opening (MO) in patients with Langenbeck or Jacob diseases after a multimodal treatment combining the coronoidectomy and a self or assisted postoperative rehabilitation. METHODS: This observational retrospective study included patients who had clinically impacted MO limitation. All patients underwent unilateral or bilateral coronoidectomy and then physical therapy for at least 3 months. MO measurements were compared between the preoperative time (M0), the immediate postoperative time (M1) and the last follow-up (M2). Other data regarding the surgical procedure and the postoperative rehabilitation were collected. RESULTS: Twenty patients were included. The MO was significantly improved from 19.15 +/- 7.02 mm at M0 to 38.00 +/- 7.62 mm at M1 (p = 0.0002). After a mean follow-up of 21.5 +/- 40.5 months, the mean MO was 32.85 +/- 5.69 mm (M2). All patients underwent coronoidectomy through an intraoral approach except for one patient who was given a combined extra-oral approach for a recurrent disease. Rehabilitation protocol included assisted physiotherapy and self-rehabilitation in 7 patients as well as just self-rehabilitation in 13 patients. No patient showed worsening or stagnation of MO. CONCLUSIONS: The multimodal treatment combining the surgical removal of the coronoid process and an active rehabilitation performed by the patient himself or assisted by a physiotherapist seems effective in Langenbeck or Jacob diseases.